Birsen DOĞANAY, Mevlüt Serdar KUYUMCU, Mustafa ÇETİN, Yücel BALBAY

A kan grubu elektif koroner anjiografi yapılan hastalarda yavaş koroner akımı

Amaç:Koroner yavaş akım (KYA), koroner arter tıkanıklığı yokluğunda, koroner arterlerde kontrastın yavaş ilerlemesi ile karakterize anjiyografik bir fenomendir. Benign bulgu olarak görülmediğinden ve hala ikna edici patofizyolojik bir açıklama olmadığı için daha fazla araştırmaya ihtiyaç vardır. Bu çalışmada, ABO kan grupları ve koroner akış karakteristikleri arasındaki ilişkiyi değerlendirmeyi amaçladık.Gereç ve Yöntemler:KYA’lı 230 hastanın klinik, laboratuvar ve anjiyografik verileri retrospektif olarak kurumsal veri tabanlarımızdan toplandı.250 yaş cinsiyet uyumlu normal koroner akımı olan hasta kontrol grubu olarak kullanıldı.Koroner akım TIMI kare sayısı kullanılarak değerlendirildi.Koroner akım özellikleri ABO kan gruplarına göre değerlendirildi.Bulgular:KYA’ltoplam 230 hasta (125 erkek, ortalama yaş: 54,6 ± 9,1 yıl) ve normal koroner akım(NKA)’lı 250 hasta (134 erkek, ortalama yaş: 53,7 ± 10,1 yıl) çalışmaya dahil edildi.KYA grubunda sigara içiciliği (33.5% vs %23.2; p=0.012), trombosit sayısı (257.2±73.3 x103/mm3 vs. 240.5±63.7 x103/mm3, p=0.011)ve ortalama trombosit hacmi(9.2±1.4 fL vs. 8.8±1.2 fL, p=0.001)NKA’lılardandaha yüksekti.A kan grubuna sahip olmak KYA grubunda,NKA’lı bireylerden daha yaygındı.Regresyon analizinde kan grubu A (OR = 1.94; p = 0.003), sigara içimi (OR = 1.57; p = 0.033), trombosit sayısı (OR = 1.03; p = 0.008) ve ortalama trombosit hacmi (OR = 1.27; p = 0.002) KYA’nınbağımsız belirleyicileri olarak bulundu.Sonuçlar:A Kan grubu, KYA grubunda daha yaygındır ve bağımsız olarak KYA'yıöngörür. Altta yatan mekanizmaları değerlendirmek için daha ileri çalışmalara ihtiyaç vardır, ancak kan grupları ve SCF arasındaki ilişki çok yönlü görünmektedir.

Anahtar Kelimeler:

Kan grubu antijenleri, tam kan sayımı, koroner yavaş akım, trombositler, TIMI kare sayısı

Blood group A predicts slow coronary flow in patients undergoing elective coronary angiography

Aim:Coronary slow flow (CSF) is an angiographic phenomenon characterized by slow progression of contrast in the coronary arteries in the absence of coronary artery obstruction. As it is not considered as benign finding and there is still no convincible pathophysiologic explanation, further research is needed. In the present study, we aimed to evaluate the relationship between ABO blood groups and coronary flow characteristics.Material and Methods: The clinical, laboratory and angiographic data of 230 patients with SCF were collected retrospectively from our institutional databases. A total of 250age- and gender-matched subjects with normal coronary flow (NCF) were used as a control group. Coronary flow was assessed by using the thrombolysis in myocardial infarction frame count (TFC). Coronary flow characteristics were evaluated according to ABO blood groups.Results:A total of230 patients with SCF (125 males, mean age: 54.6±9.1 years) and 250 subjects with NCF (134 males, mean age: 53.7±10.1 years) were included. In SCF group, cigarette smoking (33.5% vs %23.2; p=0.012), platelet count (257.2±73.3 x103/mm3 vs. 240.5±63.7 x103/mm3, p=0.011) and mean MPV (9.2±1.4 fL vs. 8.8±1.2 fL, p=0.001) were higher than subjects with NCF. Having blood group A was more common in SCF group than subjects with NCF (53.5% vs 41.2%; p=0.039).In the regression analysis, blood group A (OR=1.94; p=0.003), cigarette smoking (OR=1.57; p=0.033), platelet count (OR=1.03; p=0.008) and MPV (OR=1.27; p=0.002) were found to be as independent predictors of SCF.Conclusion:Blood group A is more common in SCF group and independently predicts SCF.Further studies are needed to evaluate the underlying mechanisms, but the relationship between blood groups and SCF seems multifactorial.

Keywords:

Blood group antigens, complete blood count, coronary slow flow, platelets, TIMI frame count,

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